MOMMIES Act

II 116TH CONGRESS 1ST SESSION S. 1343 To amend titles XIX and XXI of the Social Security Act to improve Medicaid and the Children’s Health Insurance Program for low-income mothers. IN THE SENATE OF THE UNITED STATES MAY 7, 2019 Mr. BOOKER (for himself, Ms. BALDWIN, Ms. WARREN, Ms. HARRIS, Mrs. GILLIBRAND, Mr. BLUMENTHAL, and Ms. HIRONO) introduced the fol- lowing bill; which was read twice and referred to the Committee on Fi- nance A BILL To amend titles XIX and XXI of the Social Security Act to improve Medicaid and the Children’s Health Insurance Program for low-income mothers. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Maximizing Outcomes 4 for Moms through Medicaid Improvement and Enhance- 5 ment of Services Act’’, or the ‘‘MOMMIES Act’’. 6 VerDate Sep 11 2014 19:28 May 11, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1343.IS S1343 pbinns on DSK79D2C42PROD with BILLS 2 •S 1343 IS SEC. 2. ENHANCING MEDICAID AND CHIP BENEFITS FOR 1 LOW-INCOME PREGNANT WOMEN. 2 (a) EXTENDING CONTINUOUS MEDICAID AND CHIP 3 COVERAGE FOR PREGNANT AND POSTPARTUM WOMEN.— 4 (1) MEDICAID.—Title XIX of the Social Secu- 5 rity Act (42 U.S.C. 1396 et seq.) is amended— 6 (A) in section 1902(l)(1)(A), by striking 7 ‘‘60-day period’’ and inserting ‘‘365-day pe- 8 riod’’; 9 (B) in section 1902(e)(6), by striking ‘‘60- 10 day period’’ and inserting ‘‘365-day period’’; 11 (C) in section 1903(v)(4)(A)(i), by striking 12 ‘‘60-day period’’ and inserting ‘‘365-day pe- 13 riod’’; and 14 (D) in section 1905(a), in the 4th sentence 15 in the matter following paragraph (30), by 16 striking ‘‘60-day period’’ and inserting ‘‘365- 17 day period’’. 18 (2) CHIP.—Section 2112 of the Social Security 19 Act (42 U.S.C. 1397ll) is amended by striking ‘‘60- 20 day period’’ each place it appears and inserting 21 ‘‘365-day period’’. 22 (b) REQUIRING FULL BENEFITS FOR PREGNANT 23 AND POSTPARTUM WOMEN.— 24 (1) MEDICAID.— 25 VerDate Sep 11 2014 19:28 May 11, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1343.IS S1343 pbinns on DSK79D2C42PROD with BILLS 3 •S 1343 IS (A) IN GENERAL.—Paragraph (5) of sec- 1 tion 1902(e) of the Social Security Act (24 2 U.S.C. 1396a(e)) is amended to read as follows: 3 ‘‘(5) Any woman who is eligible for medical as- 4 sistance under the State plan or a waiver of such 5 plan and who is, or who while so eligible becomes, 6 pregnant, shall continue to be eligible under the plan 7 or waiver for medical assistance through the end of 8 the month in which the 365-day period (beginning 9 on the last day of her pregnancy) ends, regardless 10 of the basis for the woman’s eligibility for medical 11 assistance, including if the woman’s eligibility for 12 medical assistance is on the basis of being preg- 13 nant.’’. 14 (B) CONFORMING AMENDMENT.—Section 15 1902(a)(10) of the Social Security Act (42 16 U.S.C. 1396a(a)(10)) is amended in the matter 17 following subparagraph (G) by striking ‘‘(VII) 18 the medical assistance’’ and all that follows 19 through ‘‘complicate pregnancy,’’. 20 (2) CHIP.—Section 2107(e)(1) of the Social 21 Security Act (42 U.S.C. 1397gg(e)(1)) is amended— 22 (A) by redesignating subparagraphs (H) 23 through (S) as subparagraphs (I) through (T), 24 respectively; and 25 VerDate Sep 11 2014 19:28 May 11, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1343.IS S1343 pbinns on DSK79D2C42PROD with BILLS 4 •S 1343 IS (B) by inserting after subparagraph (G), 1 the following: 2 ‘‘(H) Section 1902(e)(5) (requiring 365- 3 day continuous coverage for pregnant and 4 postpartum women).’’. 5 (c) REQUIRING COVERAGE OF ORAL HEALTH SERV- 6 ICES FOR PREGNANT AND POSTPARTUM WOMEN.— 7 (1) MEDICAID.—Section 1905 of the Social Se- 8 curity Act (42 U.S.C. 1396d) is amended— 9 (A) in subsection (a)(4)— 10 (i) by striking ‘‘; and (D)’’ and insert- 11 ing ‘‘; (D)’’; and 12 (ii) by inserting ‘‘; and (E) oral health 13 services for pregnant and postpartum 14 women (as defined in subsection (ff))’’ 15 after ‘‘subsection (bb))’’; and 16 (B) by adding at the end the following new 17 subsection: 18 ‘‘(ff) ORAL HEALTH SERVICES FOR PREGNANT AND 19 POSTPARTUM WOMEN.— 20 ‘‘(1) IN GENERAL.—For purposes of this title, 21 the term ‘oral health services for pregnant and 22 postpartum women’ means dental services necessary 23 to prevent disease and promote oral health, restore 24 oral structures to health and function, and treat 25 VerDate Sep 11 2014 19:28 May 11, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1343.IS S1343 pbinns on DSK79D2C42PROD with BILLS 5 •S 1343 IS emergency conditions that are furnished to a woman 1 during pregnancy (or during the 365-day period be- 2 ginning on the last day of the pregnancy). 3 ‘‘(2) COVERAGE REQUIREMENTS.—To satisfy 4 the requirement to provide oral health services for 5 pregnant and postpartum women, a State shall, at 6 a minimum, provide coverage for preventive, diag- 7 nostic, periodontal, and restorative care consistent 8 with recommendations for perinatal oral health care 9 and dental care during pregnancy from the Amer- 10 ican Academy of Pediatric Dentistry and the Amer- 11 ican College of Obstetricians and Gynecologists.’’. 12 (2) CHIP.—Section 2103(c)(5)(A) of the Social 13 Security Act (42 U.S.C. 1397cc(c)(5)(A)) is amend- 14 ed by inserting ‘‘or a targeted low-income pregnant 15 woman’’ after ‘‘targeted low-income child’’. 16 (d) MAINTENANCE OF EFFORT.— 17 (1) MEDICAID.—Section 1902 of the Social Se- 18 curity Act (42 U.S.C. 1396a) is amended— 19 (A) in paragraph (74), by striking ‘‘sub- 20 section (gg); and’’ and inserting ‘‘subsections 21 (gg) and (qq);’’; and 22 (B) by adding at the end the following new 23 subsection: 24 VerDate Sep 11 2014 19:28 May 11, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1343.IS S1343 pbinns on DSK79D2C42PROD with BILLS 6 •S 1343 IS ‘‘(qq) MAINTENANCE OF EFFORT RELATED TO LOW- 1 INCOME PREGNANT WOMEN.—For calendar quarters be- 2 ginning on or after the date of enactment of this sub- 3 section, and before January 1, 2023, no Federal payment 4 shall be made to a State under section 1903(a) for 5 amounts expended under a State plan under this title or 6 a waiver of such plan if the State— 7 ‘‘(1) has in effect under such plan eligibility 8 standards, methodologies, or procedures (including 9 any enrollment cap or other numerical limitation on 10 enrollment, any waiting list, any procedures designed 11 to delay the consideration of applications for enroll- 12 ment, or similar limitation with respect to enroll- 13 ment) for individuals described in subsection (l)(1) 14 who are eligible for medical assistance under the 15 State plan or waiver under subsection 16 (a)(10)(A)(ii)(IX) that are more restrictive than the 17 eligibility standards, methodologies, or procedures, 18 respectively, for such individuals under such plan or 19 waiver that are in effect on the date of the enact- 20 ment of the Maximizing Outcomes for Moms 21 through Medicaid Improvement and Enhancement of 22 Services Act; or 23 ‘‘(2) provides medical assistance to individuals 24 described in subsection (l)(1) who are eligible for 25 VerDate Sep 11 2014 19:28 May 11, 2019 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S1343.IS S1343 pbinns on DSK79D2C42PROD with BILLS 7 •S 1343 IS medical assistance under such plan or waiver under 1 subsection (a)(10)(A)(ii)(IX) at a level that is less 2 than the level at which the State provides such as- 3 sistance to such individuals under such plan or waiv- 4 er on the date of the enactment of the Maximizing 5 Outcomes for Moms through Medicaid Improvement 6 and Enhancement of Services Act.’’. 7 (2) CHIP.—Section 2112 of the Social Security 8 Act (42 U.S.C. 1397ll), as amended by subsection 9 (b), is further amended by adding at the end the fol- 10 lowing subsection: 11 ‘‘(g) MAINTENANCE OF EFFORT.—For calendar 12 quarters beginning on or after January 1, 2020, and be- 13 fore January 1, 2023, no payment may be made under 14 section 2105(a) with respect to a State child health plan 15 if the State— 16 ‘‘(1) has in effect under such plan eligibility 17 standards, methodologies, or procedures (including 18 any enrollment cap or other numerical limitation on 19 enrollment, any waiting list, any procedures designed 20 to delay the consideration of applications for enroll- 21 ment, or similar limitation with respect to enroll- 22 ment) for targeted low-income pregnant women that 23 are more restrictive than the eligibility standards, 24 methodologies, or procedures, respectively, under 25 VerDate Sep 11 2014 19:28 May 11, 2019 Jkt 089200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S1343.IS S1343 pbinns on DSK79D2C42PROD with BILLS 8 •S 1343 IS such plan that are in effect on the date of the enact- 1 ment of the Maximizing Outcomes for Moms 2 through Medicaid Improvement and Enhancement of 3 Services Act; or 4 ‘‘(2) provides pregnancy-related assistance to 5 targeted low-income pregnant women under such 6 plan at a level that is less than the level at which 7 the State provides such assistance to such women 8 under such plan on the date of the enactment of the 9 Maximizing Outcomes for Moms through Medicaid 10 Improvement and Enhancement of Services Act.’’. 11 (e) ENHANCED FMAP.—Section 1905 of the Social 12 Security Act (42 U.S.C. 1396d), as amended by sub- 13 section (c), is further amended— 14 (1) in subsection (b), by striking ‘‘and (aa)’’ 15 and inserting ‘‘(aa), and (gg)’’; and 16 (2) by adding at the end the following: 17 ‘‘(gg) INCREASED FMAP FOR ADDITIONAL EXPEND- 18 ITURES FOR LOW-INCOME PREGNANT WOMEN.—For cal- 19 endar quarters beginning on or after January 1, 2020, 20 notwithstanding subsection (b), the Federal medical as- 21 sistance percentage for a State, with respect to the addi- 22 tional amounts expended by such State for medical assist- 23 ance under the State plan under this title or a waiver of 24 such plan that are attributable to requirements imposed 25 VerDate Sep 11 2014 19:28 May 11, 2019 Jkt 089200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S1343.IS S1343 pbinns on DSK79D2C42PROD with BILLS 9 •S 1343 IS by the amendments made by the Maximizing Outcomes 1 for Moms through Medicaid Improvement and Enhance- 2 ment of Services Act (as determined by the Secretary), 3 shall be equal to 100 percent.’’. 4 (f) GAO STUDY AND REPORT.— 5 (1) IN GENERAL.—Not later than 1 year after 6 the date of the enactment of this Act, the Comp- 7 troller General of the United States shall submit to 8 Congress a report on the gaps in coverage for— 9 (A) pregnant women under the Medicaid 10 program under title XIX of the Social Security 11 Act (42 U.S.C. 1396 et seq.) and the Children’s 12 Health Insurance Program under title XXI of 13 the Social Security Act (42 U.S.C. 1397aa et 14 seq.); and 15 (B) postpartum women under the Medicaid 16 program and the Children’s Health Insurance 17 Program who received assistance under either 18 such program during their pregnancy. 19 (2) CONTENT OF REPORT.—The report re- 20 quired under this subsection shall include the fol- 21 lowing: 22 (A) Information about the abilities and 23 successes of State Medicaid agencies in deter- 24 mining whether pregnant and postpartum 25 VerDate Sep 11 2014 19:28 May 11, 2019 Jkt 089200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S1343.IS S1343 pbinns on DSK79D2C42PROD with BILLS 10 •S 1343 IS women are eligible under another insurance af- 1 fordability program, and in transitioning any 2 such women who are so eligible to coverage 3 under such a program, pursuant to section 4 435.1200 of the title 42, Code of Federal Regu- 5 lations (as in effect on September 1, 2018). 6 (B) Information on factors contributing to 7 gaps in coverage that disproportionately impact 8 underserved populations, including low-income 9 women, women of color, women who reside in a 10 health professional shortage area (as defined in 11 section 332(a)(1)(A) of the Public Health Serv- 12 ice Act (42 U.S.C. 254e(a)(1)(A))) or who are 13 members of a medically underserved population 14 (as defined by section 330(b)(3) of such Act 15 (42 U.S.C. 254b(b)(3)(A))). 16 (C) Recommendations for addressing and 17 reducing such gaps in coverage. 18 (D) Such other information as the Comp- 19 troller General deems necessary. 20 (g) EFFECTIVE DATE.—The amendments made by 21 subsections (a) and (b) shall take effect January 1, 2020. 22 VerDate Sep 11 2014 19:28 May 11, 2019 Jkt 089200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S1343.IS S1343 pbinns on DSK79D2C42PROD with BILLS 11 •S 1343 IS SEC. 3. MATERNITY CARE HOME DEMONSTRATION 1 PROJECT. 2 Title XIX of the Social Security Act (42 U.S.C. 1396 3 et seq.) is amended by inserting the following new section 4 after section 1946: 5 ‘‘MATERNITY CARE HOME DEMONSTRATION PROJECT 6 ‘‘SEC. 1947. (a) IN GENERAL.—Not later than 1 year 7 after the date of the enactment of this section, the Sec- 8 retary shall establish a demonstration project (in this sec- 9 tion referred to as the ‘demonstration project’) under 10 which the Secretary shall provide grants to States to enter 11 into arrangements with eligible entities to implement or 12 expand a maternity care home model for eligible individ- 13 uals. 14 ‘‘(b) DEFINITIONS.—In this section: 15 ‘‘(1) ELIGIBLE ENTITY.—The term ‘eligible en- 16 tity’ means an entity or organization that provides 17 medically accurate, comprehensive maternity services 18 to individuals who are eligible for medical assistance 19 under a State plan under this title or a waiver of 20 such a plan, and may include: 21 ‘‘(A) A freestanding birth center. 22 ‘‘(B) An entity or organization receiving 23 assistance under section 330 of the Public 24 Health Service Act. 25 ‘‘(C) A federally qualified health center. 26 VerDate Sep 11 2014 19:28 May 11, 2019 Jkt 089200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S1343.IS S1343 pbinns on DSK79D2C42PROD with BILLS 12 •S 1343 IS ‘‘(D) A rural health clinic. 1 ‘‘(E) A health facility operated by an In- 2 dian tribe or tribal organization (as those terms 3 are defined in section 4 of the Indian Health 4 Care Improvement Act). 5 ‘‘(2) ELIGIBLE INDIVIDUAL.—The term ‘eligible 6 individual’ means a pregnant woman or a formerly 7 pregnant woman during the 365-day period begin- 8 ning on the last day of her pregnancy who is— 9 ‘‘(A) enrolled in a State plan under this 10 title, a waiver of such a plan, or a State child 11 health plan under title XXI; and 12 ‘‘(B) a patient of an eligible entity which 13 has entered into an arrangement with a State 14 under subsection (g). [Text truncated for display. Full text available on Congress.gov.]